Abstract: OBJECTIVE To analyze the distribution of pathogenic bacteria and risk factors of urinary tract infections in patients with severe brain injury (SBI). METHODS A total of 156 patients with SBI from Aug. 2014 to Aug. 2016 were selected as the research subjects. The conditions of postoperative urinary tract infections in all the included patients were observed and analyzed. The factors related to postoperative urinary tract infections of patients were investigated and analyzed. The pathogenic bacteria in the urine samples of patients with postoperative urinary tract infections were detected and analyzed. RESULTS Totally 51 cases were observed with urinary tract infections, and the infection rate was 32.69%. The main clinical symptoms of patients with SBI complicated with postoperative urinary tract infections were fever, urinary tract irritation and urethral meatus itching. Totally 72 strains of pathogenic bacteria were isolated, including 35 strains of gram-negative bacteria, accounting for 48.61%, which were mainly Escherichia coli, 11 strains of gram-positive bacteria, accounting for 15.28%, which were mainly Enterococcus faecalis, and 26 strains of fungi, accounting for 36.11%, which were mainly Candida albicans. Diabetes, GCS score and indwelling catheter time were independent risk factors for urinary tract infections in SBI patients (P<0.05). CONCLUSION The related factors, clinical signs and pathogenic bacteria distribution of patients with SBI complicated with postoperative urinary tract infection have some characteristics. The clinicians should give full attention and effective treatments in order to improve the success rate of treatment of patients with SBI infection and the effects in prevention and control of nosocomial infections.